Metabolic changes in acute and subacute cerebral infarctions: findings at proton MR spectroscopic imaging.

Lanfermann, Heinrich; Kugel, H.; Heindel, Walter; Herholz, K.; Heiss, Wolf Dieter; Lackner, K.

doi:10.1148/radiology.196.1.7784568

Cited by 83 publications

(57 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 However, other studies found either an increase 5,6 or a decrease in choline levels 7,8 in stroke lesions. Discrepancies might be related to individual variability, the small sample sizes of 10 patients or less in some studies, 5,7 or to the use of different patients scanned at different time points rather than the same patients scanned at similar times.…”

Section: Discussionmentioning

confidence: 96%

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Maniega

Cvoro

Armitage

et al. 2008

Stroke

View full text Add to dashboard Cite

Background and Purpose-Choline and creatine are commonly used as denominators for other metabolites in ischemic stroke spectroscopy, assuming that they do not change. We investigated their concentration variation over time after stroke. Methods-Choline and creatine concentrations were measured by proton MR spectroscopic imaging in 51 patients at 5 times up to 3 months after stroke. Results-Choline and creatine levels changed significantly in the ischemic region. Choline was significantly reduced during the first 2 weeks after stroke onset (Pϭ0.034). Creatine was significantly reduced during the whole period of the study (Pϭ0.011). Conclusion-Choline and creatine concentrations are not reliable denominators for metabolite ratios in acute stroke because their levels vary significantly in ischemic brain regions.

show abstract

Section: Discussionmentioning

confidence: 96%

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Maniega

Cvoro

Armitage

et al. 2008

Stroke

View full text Add to dashboard Cite

show abstract

“…The observation that larger diffusion lesions were associated with lower NAA and higher lactate values is consistent with previous studies showing that large lesions on T2 weighted imaging had lower NAA and higher lactate than small lesions. 12,29,[31][32][33] We found very small amounts of lactate in the contralateral brain in some patients with large ischemic lesions and significant cerebral atrophy. This may represent leakage of lactate from large stroke lesions via CSF.…”

Section: Discussionmentioning

confidence: 99%

Associations Between Diffusion and Perfusion Parameters, N -Acetyl Aspartate, and Lactate in Acute Ischemic Stroke

Cvoro

Wardlaw

Marshall

et al. 2009

Stroke

View full text Add to dashboard Cite

Background and Purpose-In acute ischemic stroke, the amount of neuronal damage in hyperintense areas on MR diffusion imaging (DWI) is unclear. We used spectroscopic imaging to measure N-acetyl aspartate (NAA, a marker of normal neurons) and lactate (a marker of ischemia) to compare with diffusion and perfusion values in the diffusion lesion in acute ischemic stroke. Methods-We recruited patients with acute ischemic stroke prospectively and performed MR diffusion weighted (DWI), perfusion, and spectroscopic imaging. We coregistered the images, outlined the visible diffusion lesion, and extracted metabolite, perfusion, and apparent diffusion coefficient (ADC) values from the diffusion lesion. Results-42 patients were imaged, from 1.5 to 24 hours after stroke. In the DWI lesion, although NAA was reduced, there was no correlation between NAA and ADC or perfusion values.

show abstract

“…The increased Lac may reflect a change in the Lac clearance rate relative to the synthesis rate, possibly mediated by the altered expression of Lac transporters (Kuhr et al, 1988;Walz and Mukerji 1988). The persistence of high Lac levels days after ischemia in stroke patients has been proposed to reflect anerobic glycolysis by macrophages, infiltrating into the brain after ischemia (Lanfermann et al, 1995).…”

Section: In Vivo 1 H-mrs Of Ischemic Evolution In Mice H Lei Et Almentioning

confidence: 99%

Evolution of the Neurochemical Profile after Transient Focal Cerebral Ischemia in the Mouse Brain

Lei

Berthet

Hirt

et al. 2009

J Cereb Blood Flow Metab

126

View full text Add to dashboard Cite

Evolution of the neurochemical profile consisting of 19 metabolites after 30 mins of middle cerebral artery occlusion was longitudinally assessed at 3, 8 and 24 h in 6 to 8 lL volumes in the striatum using localized 1 H-magnetic resonance spectroscopy at 14.1 T. Profound changes were detected as early as 3 h after ischemia, which include elevated lactate levels in the presence of significant glucose concentrations, decreases in glutamate and a transient twofold glutamine increase, likely to be linked to the excitotoxic release of glutamate and conversion into glial glutamine. Interestingly, decreases in N-acetyl-aspartate (NAA), as well as in taurine, exceeded those in neuronal glutamate, suggesting that the putative neuronal marker NAA is rather a sensitive marker of neuronal viability. With further ischemia evolution, additional, more profound concentration decreases were detected, reflecting a disruption of cellular functions. We conclude that early changes in markers of energy metabolism, glutamate excitotoxicity and neuronal viability can be detected with high precision noninvasively in mice after stroke. Such investigations should lead to a better understanding and insight into the sequential early changes in the brain parenchyma after ischemia, which could be used for identifying new targets for neuroprotection.

show abstract

Metabolic changes in acute and subacute cerebral infarctions: findings at proton MR spectroscopic imaging.

Abstract: MR spectroscopic imaging allows visualization of metabolic changes in stroke with a reasonable spatial resolution.

Cited by 83 publications

References 0 publications

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Associations Between Diffusion and Perfusion Parameters, N -Acetyl Aspartate, and Lactate in Acute Ischemic Stroke

Evolution of the Neurochemical Profile after Transient Focal Cerebral Ischemia in the Mouse Brain

Contact Info

Product

Resources

About